C10002315 / invoice 10000

Reason: Fell At Dog ParkAppointment Notes: Overdue remindersEMERGENCYReason: Appointment Notes: Referring vet:History: went to dog park today and was knocked over by another dog. He didn't yelp or seem uncomfortable at the time but he did stop playing fetch, had less enthusiasm. Had already been there for 1.5hrs. Had a big drink and then started vomiting water.Refused to jump in the car which wasn't like him. Seemed painful in the abdomen when owner palpated the stomach.Examination:General demeanour: barTemperature: 38.5Cardiovascular: hr 100, strong pulsesRespiratory: pantingAbdomen: mild tension and repeatable discomfort in abdomen, cranial and caudalPeripheral LNs: wnlEyes/Ears: wnlIntegument: wnlOral exam: mm pinkMusculoskeletal: wnl, no spinal painGait: wnlNeurological: not assessedUrogenital: wnlRectal exam: npInitial Assessment: repeatable abdominal pain on L and R lateralPrognosis: goodDifferential Diagnosis: STI vs internal bruising/trauma vs otherInitial Plan: options to owner:1) out patient treatment2) xray/ultrasoundOwners decided 1) today.Laboratory:Radiology:Prognosis:Treatment: 0.2mg/kg methadone IMClient communication: if increased lethargy (outside of sedation from methadone), bruising, pale gums, increased panting and discomfort, bring back for reassessment and further diagnostics.Referring Vet:History emailed to referring vet :   YES / NO   Time:    Vital Signs    Weight: 34;